Surgical tables are commonly utilized to support and retain patients in a specific desirable posture during a medical procedure. While some surgical tables are intended to allow the patient's extremities to be moved during a surgical procedure, most are designed to maintain the orientation of the patient's torso, head and extremities during the procedure. While numerous surgical tables have been designed and are commercially available, very few have ever been developed specifically for use with infants and very small children. Specifically, there are no known pediatric surgical tables configured to stabilize an infant in the prone position for skull surgery.
Currently, when infants and small children are positioned for craniofacial procedures, they are placed in the face down, or prone, position on a standard surgical table manufactured for use with adults. The infant is then manipulated into the desired position by surgical staff and rolled-up towels, sponges and other soft materials, generally referred to as “bolsters”, are used to support the torso, extremities and head. The bolsters are arranged around the infant to position them in a preferred position for the specific surgical procedure. It is often necessary to tape, or otherwise secure, the bolsters to the surgical table and in some cases tape or straps are then used to secure the infant to the table.
Because of the complexity of many surgical procedures and the inherent risks associated with any surgical procedures on infants or small children, extraordinary care is necessary for the proper positioning, placement and retention of the head, neck, body and extremities. At present, surgical staff may take an hour or more to position an infant prior to craniofacial surgery. It is also common for the infant to shift during the procedure causing the bolsters to become dislodged. When this occurs, time consuming repositioning of the infant is required and the various risks associated with surgery are increased.
Because many surgeries require access to the frontal, parietal and occipital regions of an infant's head, traditional methods of strapping the infant's head in a fixed position with removable straps may be impractical. Moreover, placing an infant in the prone position creates additional risks. For example, inappropriate support of the infant's face while in the prone position increases the risk of ocular compression. Clear access is also needed to the mouth for placement of endotracheal tubes, ventilators and the like. Current methods make visual inspection of the mouth area difficult. Because drapings often are used to cover the infant's face during portions of the surgery, extended periods may occur where the mouth area cannot be visualized. Anesthesiologists generally prefer an unobstructed view of the patient's mouth. Inappropriate positioning also increases the risk of hyperextension of the neck and may diminish respiration motion as the abdomen is often compressed against the rigid surgical table.
Additional problems arise when conducting surgery on an infant strapped to a flat, rigid table. For example, urinary catheters may become trapped between the infant and the table causing injury to the infant and disrupting free flow through the tube. The line may kink or become dislodged. As the infant is typically covered in drapings, this may go unnoticed, which increases post-surgical recovery time. Incorrect positioning of the infant's arms during surgery may cause kinking of intravenous lines or otherwise cause injury or the formation of sores. A surgical table specifically configured for infant skull surgery is highly desired and needed. The invention described and claimed herein overcomes the identified deficiencies in the known apparatus and procedures related to pediatric craniofacial surgery performed on a standard operating table.